Optimal Entry Point for Retrograde Femoral Nailing with Tibial SIGN Nail in Asians: a Cadaveric Study

ABSTRACT

Purpose: To identify the optimal entry point for retrograde femoral nailing with tibial SIGN nail.Design: Descriptive analytic studyMethods: Twelve cadaveric thigh bones with attached knee joints underwent closed retrograde femoral nailing with tibial SIGN nail. After nail insertion, each femur was osteotomized at 10 cm proximal to the articular surface. Conventional radiographs were taken. Correlations between the entry point and fracture displacement were analyzed.Results: A mid intercondylar sulcus and 9 mm anterior to the femoral PCL attachment resulted in the least displacement of the femoral fracture. This entry point allowed for minimal disruption of the patellofemoral joint during knee flexion.Conclusion: When tibial SIGN nail is used in retrograde femoral nailing, a mid intercondylar sulcus and 9 mm anterior to the femoral PCL attachment provides the optimal balance of fracture reduction and sparing of the knee joint. Key words entry point, retrograde femoral nailing, tibial SIGN nail